American Families' Use of Retail-Based Health Clinics Remains Modest

Younger Families and Those with Access Problems More Likely to Use In-Store Clinics

WASHINGTON, DCDespite rapid growth of retail clinics,
only a tiny fraction of American families in 2007 had ever used the in-store
clinics, typically located in pharmacies, supermarkets and big-box retailers,
according to a national study released today by the Commonwealth Fund and conducted
by the Center for Studying Health System Change (HSC).

The number of retail clinics has grown rapidly in recent years, from about
60 retail clinics in 18 states at the beginning of 2006 to more than 900 in
30 states by the end of 2007.

As of 2007, 2.3 percent of American families, or nearly 3.4 million families,
had ever used a retail clinic, according to findings from HSCs 2007 Health
Tracking Household Survey, a nationally representative survey with information
on about 18,000 people in 9,400 families. The survey had a 43 percent response
rate.

Of the families reporting they had ever used a retail clinic, about half reported
visiting a retail clinic in the prior 12 months before the survey interview,
while the other half reported they had visited a retail clinic during an earlier
period.

The study found that families that reported not getting or delaying needed
medical care at some point in the previous 12 months were almost 2.5 times as
likely to have used a retail clinic as families without such access problems
(1.9% vs. 0.8%). Also, younger families-those with a family respondent aged
18-34-were more than twice as likely as older families-those with a family respondent
aged 50-64-to have used a retail clinic.

"While overall use of retail clinics remains modest, families with unmet
medical needs tend to use the clinics more than the rest of the population,"
said Ha T. Tu, M.P.A., an HSC senior researcher and coauthor of the study with
Genna R. Cohen, an HSC health research assistant.

"These findings suggest that retail health clinics have the potential
to play a role in improving health care delivery, especially primary care,"
said Commonwealth Fund Vice President Anne-Marie Audet, M.D.

Among all families that used retail clinics in the past year, uninsured
families-defined as families with any member lacking health insurance-accounted
for 27 percent of clinic users, the study found.

Nearly half (48%) of all consumers using retail clinics reported they
had done so for diagnosis and treatment of a new illness or symptom. Almost
as many (47%) said that their visit had included a prescription renewal. Other
less common reasons cited by consumers were vaccinations, care for an ongoing
chronic condition and physical examinations.

Almost two in three people said that the clinics convenient hours were
a major factor in choosing it over another source of care. The convenience of
the clinics location and the ability to receive care without an appointment
also were commonly cited as major reasons for choosing clinics. Seven of eight
clinic users cited at least one of these three convenience factors as a major
reason for choosing clinics, and one in three cited all three convenience factors
as major reasons.

Nearly half of all clinic users cited the low cost of a clinic visit
relative to other care settings, and one in three cited not having a usual source
of medical care, as major reasons for choosing clinics over other care settings.

The likelihood of citing cost concerns and the lack of a usual source
of care as major factors were much higher among uninsured and minority clinic
users, compared with their insured and white counterparts, respectively. For
example, uninsured clinic users were more than 3.5 times more likely than insured
clinic users to cite not having a usual source of care as a major reason for
choosing clinics over other care settings.

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The Commonwealth Fund is a private foundation working to promote a high
performing health care system that achieves better access, improved quality,
and greater efficiency, particularly for societys most vulnerable. The Fund
carries out this mandate by supporting independent research on health care issues
and making grants to improve health care practice and policy.

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The Center for Studying Health System Change is a nonpartisan policy research
organization committed to providing objective and timely research on the nations
changing health system to help inform policy makers and contribute to better
health care policy. HSC, based in Washington, D.C., is funded principally by
the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy
Research, Inc.